Provider Demographics
NPI:1700856523
Name:TERHORST, ANN M (ARNP, CWOCN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:TERHORST
Suffix:
Gender:F
Credentials:ARNP, CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 16TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-2924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 LINCOLN CIR SE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1862
Practice Address - Country:US
Practice Address - Phone:712-737-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089886163WE0900X, 364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1462119Medicaid
IA02440OtherBCBS PROFESSIONAL
IA1462119Medicaid